Individual provider Active NPI

Stacey Lynn Gardner, ALC

  • Mental Health Counselor
  • Madison, AL
National Provider Identifier
1801502711
Registry record updated Jan 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
ALC04091 Issued in AL
Practice address
401 Hughes Rd Ste 2
Madison, AL 35758-1144
Phone
(412) 287-7088
NPI assigned
Jan 24, 2023
Last updated
Jan 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X ALC04091 AL Primary

Addresses

Primary practice location

401 Hughes Rd Ste 2
Madison, AL 35758-1144

Mailing address

110 Mill Walk CT
Madison, AL 35758-1545
Phone (412) 287-7088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ALC04091ALMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
To Be Seen Counseling, LLC Mental Health PastSince Jan 29, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1801502711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MILL WALK CT",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581545",
            "telephone_number": "412-287-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HUGHES RD STE 2",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357581144",
            "telephone_number": "412-287-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "STACEY",
        "middle_name": "LYNN",
        "credential": "ALC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AL",
            "license": "ALC04091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.